مجله ایرانی آموزش در علوم پزشکی
سال دهم شماره 5 (پیاپی 29، زمستان 1389)

Pre conception care is set of care services to assess the risks for pregnancy, it provide training and diagnostic measures, therapeutic and pharmaceutical interventions for improving health woman. In addition to improving health and performing medical care in Pre conception care, main point is to empower individual to maintain their health through providing education and counseling. Therefore, according to recommendations presented in the guidelines, the protocol of Pre conception care was prepared. This study aimed to assess the Effect of this protocol on eligible women's awareness. This is a Field trial were performed in 1385 to 1386 in the Shahreza (one of the Isfahan cities). Four hundred eighty (480) married women aged 49-15 who referred to health units for getting family planning services referred to health units and were selected randomly. Study was designed in three stages. In the first stage in four health-centers (two urban and two rural centers) basic knowledge of study sample were determined. Protocol of pre- pregnancy care for all spacing women in case centers (a urban center and a rural center) was implemented. Then in the second and third stages (three and six months after implementation of the protocol) women’s awareness was measured again. Results (post Test and lasting knowledge test) in the case and control groups, also before, and after the protocol were compared. Data collection was done by a questionnaire. Validity of questionnaire was confirmed through expert opinion and reliability was confirmed through calculating Cronbach's Alpha (0.8). Data analysis was done by SPSS software using t-test. Results showed that pre-pregnancy care protocol implementation leading to significant increasing of secondary awareness and lasting knowledge in case group (Respectively p<0/0007, p<0/001) Since the implementation of the protocol will lead to increased awareness of mothers, health workers must try to implement these cares completely and properly.

Using multiple choice question tests, as an objective testing method, is the most common students evaluation procedure, and it is very important to design these tests properly.This study aimed to assess clerkship tests of general medicine courses in the training group of dermatology, psychiatry, gynecology, ophthalmology and neurology of medical college of Isfahan University of Medical Sciences both quantitatively and qualitatively. This descriptive cross- sectional study was done on the latest tests of clerkship courses of general medicine including dermatology, psychiatry, gynecology, ophthalmology, and neurology in 2008. The quantitative and qualitative indexes of 15 previously held tests were extracted by using valid and reliable checklists used for determining questions with inappropriate question discrimination index, difficulty coefficient, question with 3 choices of zero, reliability coefficient, question distribution based on the announced topics, the scope of questions based on the objectives, the question types based on taxonomy. Data were analyzed through SPSS software using descriptive statistics. Among the quantitative indexes, mean of queations with inappopriate discrimination index was 24%, difficult questions 4.1%, and questions with 3 choices of zero was 12.9%. The average of questions distribution basedon the announced topics and the reliability coefficient were 98% and 77.92%, respectively. among the qualitative indexes, the highest relative frequency of questions were in the fild of signs and symptoms with 30.75 % and the first taxonomy with 59 %. Considering the importance of using standard questions (which are according to the rules for designing multiple choise question) for holding appropriate exams, continuous review of test questions and administering training courses on test questions designing, creating question banks and putting emphasis on preparing two dimensional tables for tests before giving exams are effective on improvement of the quality of the questions.

Curriculum assessment is part of educational systems. In the absence of an assessment of present situations, any intervention would be futile. This study was done to determine achievement rate of medical students in advanced clerkship (externship) courses through using logbooks. This retrospective cross-sectional descriptive study was done on medical student's logbooks between June and December 2010 in Isfahan University of Medical Sciences. The students were passing their externship courses. Random sampling was done and 30 logbooks from departments of orthopedics, ENT, neurology, anesthesiology and toxicology, infectious diseases, and internal medicine were analyzed; descriptive statistics and SPSS were used for data analysis. 180 logbook tables were analyzed. Average number of skill performances supervised once or more were found to be: 8 (out of 10) skills in anesthesiology and toxicology, 5(out of 11) skills in infectios diseases,7(out of 20)skills in internal medicine, 8 (out of 13) skills in orthopedics, 11 (out of 11) in ENT, and 10 (out of 10) in neurology. Findings showed that actual skills achievement is far from ideal in the studied departments. Therefore, interventional measures such as involving residents in instruction, more practical instructions in CSLC, using instructional films,arranging hospital shifts for interns, applying OSCEs, etc. shoud be taken.

Necessity for promotion of education quality in course of medicine forced the educational authorities including those of Isfahan school of Medicine to take actions towards promotion of education using an accreditation evaluation model in this course parallel to worldwide motion. This article emphasizes on a model by which this study was conducted and reported. This is a descriptive study conducted on seven domains of general medicine curriculum. In the model used in this study, in addition to the current condition, optimal condition was determined. If 70% of the indicators were appropriate in each domain, that domain was considered as appropriate, between 40-70% as semi appropriate and less than 40% was considered as inappropriate. The study was conducted in some steps including forming internal assessment committee, determining factors criteria and indicators, holding educational workshop, preparing data collection tool, data collection and analysis, report preparation and suggestions. In domain of mission 70%, educational planning 80%, faculty members 74%, resources 54%, top and executive management 75%, student 34%, evaluation 61% and finally overall ratio 57% of the indicators were appropriate. Domains of student, resources and evaluation need continuous programming and working. Researchers have some suggestions including taking defined strategies for selecting education managers, using modern educational policies, reinforcing tests assessment system and increasing school authority in having clinical education resources.

Educational evaluation is one of the main elements of educational systems. It also has a particular role in different educational standards such as ISO 10015. It seems that oral and written examinations are not enough for an effective evaluation of instructions. In order to accomplish an efficient educational evaluation, an evaluation model was designed for educational assessment of modular courses so that, it could assess the most effective factors on education.

After developing the first draft of the proposed model, it was developed and improved using Delphi technique and then implemented in 11 modular educational programs for managers and administrators of selected hospitals and vice chancellors for logistics of medical universities. Finally, it was introduced as the proposed model.

The proposed model included 9 evaluation domain and consisted of 134 factors as follows: daily evaluation of the class by learners (10 factors), daily evaluation of educational and welfare facilities by learners (12 factors), final course evaluation by learners (30 factors), course evaluation by teacher (20 factors), learner's evaluation of the effects of education in practice (7 factors), evaluation of educational resources (6 factors), learners’ evaluation of the content (16 factors), and learner's self evaluation of educational efficiency (13 factors).

In order to facilitate the achievement of educational objectives, educational system should make use of appropriate evaluation methods. Therefore, the above mentioned model was presented as a method for evaluation of modular education and development of educational systems.

How to communicate and interact with the patient play an effective role in patient satisfaction, treatment outcome, psychological effects, medical costs, clinical competence of physician, and even patient’s complaining. these skills can be learned. Studies showed that physician did not receive enough training regarding general communication skills. this study aimed to provide a tool to strengthen communication skills of medical students in an effective and simple manner. This quasi-experimental intervention study was performed on medical students of Isfahan University of Medical Sciences in Internship period in 1388. Participants were randomized to the intervention and control groups (75 student in each group). intervention group received the tool were developed for guiding physicians to communicate with patient. After two months, physician- patient communication in two groups was assessed and compared. Finally, data analysis was performed with spss software. The overall mean was 29/36±7/2. mean score in both intervention and control groups were 32/5±7 and 26/19±5/91 respectively. the mean difference between two groups was 6/35. Difference between intervention and control groups was significant (p<0/001). The results showed the use of educational tools are effective on communication with patients. Education about effective communication with patients should be considered in educational material for medical students.

Prevailing confidence in an organization has relationship with efficacy, conflict reduction and job satisfaction Since, confidence is a crucial factor in structuring educational hospitals, this study has tried to investigate trust and nursing personnel's confidence building and their job Satisfaction in Isfahan university of Medical Sciences. This is a descriptive analytic study. The target population included nurses in educational hospitals in Isfahan University of Medical Sciences in 2008. The samples (111) were selected through random sampling. Data were collected by Sashkin questionnaire of job confidence (1999) with reliability of 98% and lessler job satisfaction questionnaire (1984) with reliability of 80%. Data were analyzed by descriptive statistics, T-test and coefficient index. The findings showed that there was a relationship between nurse's level of job satisfaction and organizational confidence. Mean scores of job security, supervision and salary were the highest in nurse's job satisfaction regarding confidence dimensions. The results obtained by data analysis in main hypotheses of the study showed a relationship between nursing personnel's organizational confidence and their job satisfaction. In other words, the more the nurses rely on organizational managers, the more job satisfaction they will have.

One of the ways to modify education is to design clinical education courses based on advanced learning models with systemic collaboration of programmed spheres of practice variables. Nurses and academic members in nursing and medical schools play a key role in professional and personal promotion of nursing students. This study adopted synergy model to determine and assess patients’ and nurses’ characteristics. This is an action research. Synergy model was performed for 12 MSc nursing students (term two in CCU and Cardiac surgery ICU) selected by convenient sampling. The study was carried out in CCU of Nour and Cardiac surgery ICU and Cardiac surgery ward of Shahid Chamran hospitals of Isfahan University of Medical Sciences in the second semesters of 2008-2009 and 2009-2010. The data were collected by patients’ nurses’ characteristics questionnaire and levelizing them using synergy model with confirmed validity and reliability. The judgement in this study was based on mean score. Mean score of levelizing of nursing students’ characteritstics made by instructors and nurses showed that mean score in students’ function scale in clinical judgement was 3 (average), in advocacy and moral agcncy 1 (the lowest), in caring practices 3(average) in interdisciplinary collaboration 3, in systematic thinking 3 (average), in response to diversity 1 (the lowest), in facilitation of learning 3 (average) and in clinical inquiry 1 (the lowest)respectively. The findings of this study showed the need to promote mutual cooperation between nursing and medical schools and hospitals in education of nursing students and to promote care for clients and their families in a systematic planning framework. Synergy model is a functional approach for planned education and its development so that the students can aquire the ability to response to patients’ and their families’ needs in form of a learning system.

To make association between basic sciences and clinical courses of medicine is an established essential, which highly contributes to a better and more accurate learning of clinical concepts and disease diagnosis and therapy among students. This study investigated medical student's viewpoints toward presentation of clinical physiology lesson. In this action research, clinical physiology was presented for the first time as an optional course during the first semester of 2007-2008 academic years in the list of courses for medical students of 4th semester in Isfahan University of Medical sciences. Student's viewpoints toward presentation of this course were evaluated through a researcher-made questionnaire. Data was analyzed by SPSS software using descriptive statistics (mean and standard deviation). Total mean score and standard deviation of questionnaire is 48.18±0.38 which shows student's positive attitude toward presentation of clinical physiology course. Mean score and standard deviation of student's satisfaction with presentation of this course was 9.53±0.46, which shows their approval. regarding the findings of the study, positive attitude of the students, and their interest to clinical physiology, it is recommended to present this course to students as an optional module in Isfahan University of Medical Sciences.

Applicability of theoretical material in basic sciences courses of medicine discipline plays an important role in enhancing student's motivation and interest to the lessons. This study aimed to assess the effects of integrating physiology lessons to clinical and para-clinical findings on student's attitude and motivation toward physiology lesson. This pre-experimental study was performed on 75 medical students of semester 4 in Isfahan University of Medical Sciences. Along with studying theoretical materials of physiology, students attended in clinical and para-clinical wards of educational hospitals and were acquainted with physiologic basis of diseases. Student's attitude, motivation, and interest towards physiology were evaluated before and after integration. The study method was also assessed after integration using a questionnaire. Data was analyzed by SPSS software using mean, standard deviation, and comparisons was done by t-test. Findings showed that student's interest in attending study which was 15.30±0.25 before the program, enhanced to 17.38±0.35 after that (p>0.05). On the other hand, study of student's attitude toward physiology lesson revealed mean score and standard deviation of 11.30±0.33 before integration which enhanced to 16.71±0.25 after integration and confirmed a significant difference. Assessing the teaching method and general settings of course conduction disclosed 19.08 score out of total score of twenty. Attendance at hospital and contact to the patients along with theoretical education can increase internal motivation and improve student's attitude toward basic sciences courses and physiology particularly.

Internal assessment is a part of accreditation process to improve the educational quality through academic members’ cooperation. This study aimed to determine the status of pharmacy curriculum through in Isfahan School of Pharmacy and Pharmaceutical Sciences (within 2008-2009) applying the internal assessment process. This is a descriptive cross-sectional study. Firstly, school internal assessment committee was formed and then areas, indicators, standards and appropriateness ranges were determined. Data collection was done by the checklists and questionnaires (some of which were researcher-designed and some were used before and their validity and reliability had been confirmed). Target population including students, academic members, and managers filled the checklists and questionnaires and other experts involved in related fields. In addition, documentation analysis was done. The data were analyzed by descriptive statistical tests through SPSS software. The school score was assessed appropriate (over 75% of total score) in all seven areas including mission and educational goals, management and organization, curriculum, educational recourses, academic members, students, evaluation and measurement. Main indicators of weakness in some areas included relative satisfaction of academic members and students with working condition, job promotion and teaching quality, lack of enough educational pharmacies and academic members in some educational departments as well as shortage of a logbook for clerkship course, respectively. Appropriateness for most of indicators may be due to the long history of Isfahan School of Pharmacy and its scientific and academic structure. Since the indicators do not have the same efficacy in different areas, possible weaknesses or relative inappropriateness should not be ignored in some areas.

Clinical education has a remarkable importance in medical education. Awareness of dentistry students’ view from the educational setting, faculty and nurses will help on developing strategies for qualitative and quantitative improvement of clinical training. This study aimed to assess Isfahan Dental School students’ satisfaction and views or satisfaction of clinical setting, in order to gain insight about its strengths and weaknesses. In a cross-sectional study, all of students of Isfahan Dental School in one educational year (1388) were asked to fill a questionnaire with 16 standard questions. The questionnaire was about student’s satisfaction from teachers, nurses, equipments and facilities of clinical setting, student’s self-steams and satisfaction of their action in clinical practices. The data was analyzed by SPSS software using descriptive statistics, ANOVA and t-test. There was a significant statistically difference between the mean score of satisfaction of different departments. Maximum satisfaction in all components was shown in periodontics and orthodontics departments and minimum satisfaction was shown in endodontic and prosthodontics departments. There was a negative correlation between their satisfactions and their final grades, but this correlation was not statistically significant. Results showed that despite significant differences between satisfaction of different clinical departments, students’ satisfaction from different departments is desirable. However, it is suggested to consider in future planning prosthodontics and endodontic departments as a priority.

Assessment tools of academic achievement in the field of surgery have always been received considerable attention. The issue that has received less attention is that which one of these methods has higher efficiency to cover appropriately educational objectives in surgical groups. This survey aimed to evaluate the results of three examinations (including OSCE, in-group educational assessment, final improvement examination) of neurosurgical assistants of Isfahan University of Medical Sciences in 2009-2010. In this retrospective cross-sectional study, results of examinations (OSCE, the annual improvement examination and in-group educational assessment) of neurosurgical assistants of Isfahan University of Medical Sciences were investigated. Scores from all three tests were extracted and analyzed. The 1-4 academic -year's scores of 15 individuals from 18 residents were analyzed. The results of these exams showed that there is a significant difference between the scores in OSCE, the annual improvement examination and in-group educational assessment. This difference for the results of in-group exam was significant in comparison with the two other exams (p=0.000), but the results did not show significant difference (p=0.21) for annual improvement examination in comparison with OSCE. In addition, high grade residents’ score in OSCE and in-group was somehow similar and their mean rank was close together. But their scores in in-group exams showed considerable difference. Although annual improvement examination will be held as MCQ, and measures scientific and cognitive assistants’ ability and OSCE essentially assess psychomotor capabilities, but accurate planning and applying the MCQ is effective on its result. Holding annual improvement examination as focused, its proper conducting by Medical Education Development Center, participating all professors in designing questions, proper questions distributing of all references, applying two axes table tables for designing questions, its quality, adherence to the principles of designing question, using more than 70 percent questions in the taxonomy of two or three are factors which are effective for closing this test to the standard tests and making an accepted tests for assessing academic progress and differentiating assistants.

Theoretical courses exams are important tools for evaluating medical students’ capability in starting clinical training. Because of the importance of these courses in clinical training for midwifery students, the evaluation of quality of these tools is necessary. Therefore, in this study the validity of exam and the degree of correspondence between the questions and learning levels were evaluated. This descriptive study was done to evaluate the exams of 18 core theoretical midwifery courses. Data collection was done through check list. The content, face and criterion validity of the exams as well as the correspondence between learning expectancy level and questions based on Bloom category were evaluated by medical education experts. The validity and reliability of experts’ evaluations were confirmed in a pilot study. Data were analyzed by means of Pearson Correlation Coefficient and Spearman. The evaluation of 1013 questions (in 18 courses) showed that 92.38% of the questions had content validity and 80.45% had face validity. Also, eleven exams had criterion validity. The highest correspondence rate was 71.4% and more than 50% of the questions corresponded with learning expectancy level. In 61.11% of exams the relationship between the questions and the learning expectancy level was significant. According to this study, although the questions have been designed in a manner to evaluate the related content, in a significant number of exams the questions and learning expectancy level did not correspond. Also, some questions did not follow a standard structure. It is, therefore, necessary for the teachers to pay attention to these points.

We aimed to assess the outcomes of critical appraisal method beside lecturing versus lecturing method regarding theoretical sections among the student of msc of nutritional science. This semi-experimental study was undertaken on 8 students of nutritional science in two semesters during 2009-2010. Some sections were taught via using critique of original articles, but others were taught using exclusive lecturing method. We assessed student’s Knowledge by using a written examination, attitude via a 5 item-questionnaire and Skill via writing a review paper. SPSS software was used to analysis of data and student t test was used to compare the scores in two sections. The mean of knowledge, attitude and skill grades in post-test were significantly higher in the critical appraisal sections (18.1±4.2 vs 15.9± 3.5; P=0.03, 4.0±3.5 vs 1.0±0.2; P=0.02 and 18.5±2.5 vs 15.0±3.5; P=0.04, respectively). teaching the theoretical sections beside criticizing of papers improves the knowledge, attitude and skill grades.

Cardiopulmonary arrest is one of the main medical urgencies. Studies show that 20% to 30% of patients could be resuscitated via an efficient cardio-pulmonary resuscitation (CPR). Training CPR through interprofessional method could lead to improving the performance of resuscitation group. The aim of this research was to study the effects of Interprofessional training on resuscitation group's teamwork performance.

This was a quasi-experimental study of nonequivalent control group design performed in Kurdistan University of Medical Sciences in the year 2010. At first an Interprofessional study guide for CPR education was developed. Then 60 health care employees including physicians, nurses, anesthesia technicians, and operating room technicians were selected through stratified sampling and were divided into two control and intervention groups. The control group was trained via the routine method, and the intervention group was trained through interprofessional method using the study guide. A checklist was designed for assessing teamwork performance. Then, pre-test and post-test was administered for both groups. The gathered data was analyzed by SPSS software using Mann Withney U Test.

The findings revealed that intervention group’s score of teamwork performance increased significantly compared to the achieved score in pretest (p=0.00). After intervention also, teamwork performance score for intervention group was significantly higher than that of the control group (p=0.00).

Education along with other professions and using additional active learning methods could lead to the improvement in teamwork performance. This kind of education can improve the relationship between professions and train a compatible group of responsible professionals which can bring about a high quality health care service to the patients and lead to decreasing the side effects of diseases.

Medical related professions require continuous deliberated learning in order to promote medical services. It is optimal that students start their professional education with adequate understanding and ability for deliberated learning. This study was conducted to assess the validity and reliability of the questionnaire designed for assessing deliberated learning.

This is a descriptive cross-sectional study conducted on 125 first year students (including nursing, midwifery and operation room student) of Nursing and Midwifery School of Isfahan University of Medical Sciences. In the questionnaire, including 28 questions related to various aspects of deliberated learning. the first section reviews 22 specific questions related to deliberated learning and Section II, the general factors influencing the students‘ motivation for deliberated learning (such as using the Internet for curriculum issues, the amount of hours spending on extracurricular activities, the average hours of personal study and the average daily sleep).

Based on finding factors affecting deliberated learning are time management, motivation and perseverance, learning style, self-regulatory factors, Iranian and indigenous education curriculum planning. There was no significant relationship (p<0/05) between deliberated learning and using the Internet in order to provide cached Course Topics (r=0/42), the amount of hours devoted to extracurricular activities (r=0/42), average daily hours of personal study (r=0/3) and average sleep hours during day(r=0/32).

Students with deliberated practice mange their learning process and have the necessary skills required to access and process information. Intellectual skills and mental strategies for deliberated learning can be learn and teach. It will increase academic achievement and ultimately, continued learning.

Medical related professions require continuous deliberated learning in order to promote medical services. It is optimal that students start their professional education with adequate understanding and ability for deliberated learning. This study was conducted to assess the validity and reliability of the questionnaire designed for assessing deliberated learning. This is a descriptive cross-sectional study conducted on 125 first year students (including nursing, midwifery and operation room student) of Nursing and Midwifery School of Isfahan University of Medical Sciences. In the questionnaire, including 28 questions related to various aspects of deliberated learning. the first section reviews 22 specific questions related to deliberated learning and Section II, the general factors influencing the students‘ motivation for deliberated learning (such as using the Internet for curriculum issues, the amount of hours spending on extracurricular activities, the average hours of personal study and the average daily sleep). Based on finding factors affecting deliberated learning are time management, motivation and perseverance, learning style, self-regulatory factors, Iranian and indigenous education curriculum planning. There was no significant relationship (p<0/05) between deliberated learning and using the Internet in order to provide cached Course Topics (r=0/42), the amount of hours devoted to extracurricular activities (r=0/42), average daily hours of personal study (r=0/3) and average sleep hours during day(r=0/32). Students with deliberated practice mange their learning process and have the necessary skills required to access and process information. Intellectual skills and mental strategies for deliberated learning can be learn and teach. It will increase academic achievement and ultimately, continued learning.

Medical students are exposed to variety of stresses which may have effects on their education and health. In this situation "student support systems" are necessary. In Medical School of Isfahan University of Medical Sciences for achieving to the goal of supporting and guiding medical students, Tutor Scheme has been organized. In this study efficacy of the tutor scheme and satisfaction of students and tutors is being evaluated. This cross-sectional study was done in the Medical School of Isfahan University of Medical Sciences. Target population was all the students that were supported by the scheme (466) and all the tutors (42). Information was taken by 2 types of questionnaire that were prepared by the researcher. 93.3% of tutors and 72.6% of students thought that it is necessary to have a tutor but there was significant difference between their point of view (p<0.0001). 51.06% of tutors and 25.5% of students were satisfied or very satisfied by the scheme and there was significant difference between their point of view (p<0.0001). Satisfaction in tutors and students was linked with same issues such as initiation of meetings by the faculty, holding meetings during the year by tutor, including social and personal discussions besides academics, participating in monthly meetings, importance of the regularity of meetings, holding meetings in special times such as pre exams periods, having the choice to select or change tutor, performing workshops and group sessions for tutors and paying attention to encouraging tutors. 28.9% of the students hadn’t had any meeting with their tutors and 7.8% that were all guest or displaced students didn’t have tutor. tutors and students both think that having tutor is necessary but the low percentage of satisfaction shows that the scheme needs revision and some changes and also needs providing some facilities.

The duty of physicians in new world is to promote health, prevent diseases and deliver primary health care. Hence there is need for physicians who are able and skilled according to the needs of society. The goal of this study is to determine the needs of general physicians working in rural health centers of Esfahan province in five health domains. In this descriptive-survey study viewpoints of 183 general physicians working in rural health centers of Esfahan province were studied. A questioner composed of two sections, demographics and 91 topics in five domains, including health education, psychological health, oral and dental health, family health, health providers training courses (Behvarzi) and also health network development was prepared. The topics were determined based on viewpoints, literature review, national and international studies and rural insurance guidelines. The determined needs were prioritized. The most important educational needs of physicians in different domains are: psychological health, family health& population, health education, dental& oral health, health providers training courses and also health network development. The first priority in each domain was as follows: psychological health: drug therapy in psychiatry, family health& population: drug resistant infections in women, health education: consultation principles, oral& dental health: diet control for oral& dental health, in health network development& health providers training courses: crisis management and duties of health providers (Behvarz). The physicians felt that psychological health is the first educational need and health providers training courses the last one. Considering the results of physicians needs assessment, it is suggested these five domains be included into continuing educational courses for physicians to enhance the efficiency of family physician programs.

Our country needs expert nurses who are professional in family nursing. As a result, it is required to determine their professional duties as a basis for future planning for new disciplines and new majors such as family nursing. This study is an endeavor to determine a portion of professional tasks of family nurses via the viewpoints of physicians (family physicians and specialists), families, nurses, managers of health care centers, and administrators of private and public hospitals. In this descriptive cross-sectional study in the year 2010 in Isfahan, study population included multiple groups of families who were covered by Isfahan health centers, nurses employed in public hospitals of Isfahan, family physicians, specialists, and managers of private and public health care centers. Families and nurses were selected through multi-stage cluster sampling, family physicians and specialist were chosen via simple random sampling, and managers were selected randomly among managers volunteered for participation in the study. Data gathering method was interview and focus groups were employed for completing and modifying the tasks. After determining the viewpoints, the tasks were categorized based on interview items and research objectives. Overlapping items and the number of repetitions were determined and were written beside each item. Based on the viewpoints of study groups, 59 items were determined from familie's viewpoints, 30 items from nurses', 25 items from family physicians', 15 items from family physicians', and 31 items from managers. After integration, elimination of the repeated items, and finalization in focus group, 32 items were remained. With regard to the need for future planning to train family nurses, there is a need for defining their professional tasks. Findings of the study could be used in curriculum development of this discipline.

The aim of this study was to use Classical Test Theory (CTT) software for qualitative and quantitative analysis of Multiple Choice Questions (MCQ) for Master students of health discipline. This study was carried out on two groups each including 50 undergraduate students of public health, and two groups of 50 and 26 undergraduate students of occupational health. The final exams were done to determine academic achievement of students using MCQ during the years 2004 and 2005 in the department of environmental health, school of health in Isfahan University of Medical Sciences. The questions were analyzed by CTT software in two phases before and after quantative analysis. Having qualitative analysis performed, the questions set for the first stage exam were modified. At the following year, another group of students were examined using those modified questions of the first stage. Reliability coefficient for two exams of industrial solid wastes and health of water, before the quantitative analysis of the questions, were obtained 0.576, and 0.359, respectively. After quantitative analysis of these questions, the coefficients values improved to 0.671 and 0.694, respectively. The method of question analysis in this study led to improving reliability coefficient in the second stage. This coefficient is still far away from desirable coefficient (reliability coefficient greater than 0.8). Therefore, these questions still need to be modified, and analyzed again using the CTT software.

Public health services system needs nurses with problem solving and critical thinking skills. Thus, teaching methods must be applied to nurture these skills in students. This issue has led to attention toward Problem-Based Learning (PBL) in nursing. This study was done to investigate the effect of PBL in nursing through reviewing the related literature. Using the key words PBL, nursing education, and clinical environment, all the related studies done between 2000 and 2010 were selected on Medline, Proquest, and Ovid. The studies were then assessed based on learning stages occurring in PBL and 18 researches were selected. The researches supported the positive effects of PBL method in theoretical and clinical nursing education. This study suggested that PBL promotes learning, critical thinking and conflict resolution skills. Considering the findings of the studied research papers, it is suggested that PBL be applied in teaching theoretical and clinical courses of nursing. Also nursing schools administrators should provide the proper conditions for applying this teaching method.

Identifying the educational needs is an essential step in planning faculty development and plays an important role in promoting the quality of education. The aim of this study was determination of the educational needs and its prioritization of faculty members in medical school of Isfahan University of Medical Sciences. In this descriptive cross-sectional study, a questionnaire was developed using the indices identified in an opinion poll, reviewing the literature and similar foreign and Iranian studies, and a guideline about six areas of faculty member's job description. The questionnaire was sent to all basic faculty members of school of medicine (n=70). The items were scored from one to 20 according to the importance of the educational need. Data were analyzed by SPSS software using the mean and standard deviation statistical indices. Different areas of educational needs were respectively prioritized as administrative and executive activities, personal development, research, and education, specialized activities outside the university and health services and health promotion. Faculty members need all these six major areas specially the area of administrative and executive activities. The area of education was not fully regarded as expected. It is recommended to determine the weight development of all these six areas using a standard method.

Women's worldwide tendency toward higher education has been controversial in recent decades and Iran is not an exception in this regard. On the other hand, the education level could be related to women's mental health. Hence, this study was performed to determine this relationship and elucidate the query if the mental health enhances along with enhancement of educational level. In this descriptive-correlative study in August 2008 in Isfahan University of Medical Sciences, 120 female students were selected through random sampling method. Data gathering tool was standard questionnaire of Goldberg for public health (Goldberg Health Questionnaire) and demographic data form for respondents. Collected data was analyzed by SPSS software using descriptive and inferential statistics. A significant statistical difference was observed between mean of mental health of Master degree students compared to that of Bachelor and PhD students; i.e. among the total study population, Master degree students had a higher level of mental health. In other words, there was a significant relationship between mental health of female students and their educational level. Similarly, a significant difference was observed between their mental health condition and factors such as occupational status (being employed or unemployed) and marital status (P<0.05). In other words employed women compared to unemployed and married women compared to single women enjoyed higher level of mental health. Educated women's mental health could be related to their getting married or employed. Therefore, dissemination of an appropriate marriage culture among woman who follow higher education, appropriate application of their abilities, and their assignment into right occupations are essential factors determining their mental health. More studies are needed to explore the association between reduction of mental health and continuing education in PhD level.

SPICES is an approach to assist curriculum planners while planning, reviewing or revising a curriculum. However, in the literature, there are few published papers describing the application of SPICES criteria for curriculum evaluation. The goal of this study is development of curriculum evaluation tool based on community-based strategy in SPICES model. This developmental study had two phases. The first phase was concept mapping and questionnaire development, which was performed as an extensive literature review and consensus in focus groups of experts. The content and face validity of questionnaire were checked by educational experts, and its reliability was checked by Cronbach's Alpha. The second phase was using the questionnaire to evaluate internal medicine clinical course in Isfahan University of Medical Sciences. Frequency of items selected by students was used to determine the location on the continuums. internal medicine clinical course were located in the traditional end of community-based continuum in terms of resources, teaching and learning methods, disease type, diagnostic and treatment approaches, course management and organization, assessment of knowledge, assessment of skills, levels of care in tests. Teaching preventive and rehabilitation approaches were placed out of the left end of continuums. Only teaching practical skills was found to be community based in internal medicine course. Such an evaluation can not only reveals the current location of medical schools on continuums but also reflects their future vision.

Various studies show that Log book can be also used in evaluation of medical course curriculum in clinical level in addition to evaluation of students’ achievement and their level of competencies. This article was to investigate the applicability of this new usage of Log book.

Logbooks were designed by faculty members through various sessions in clinical departments in six sections of introduction, outcomes and essentials of learning, disease exposure case reports, communication skills evaluation, procedural skills learning in the morning and at the time of shift. Logbooks were filled by students and returned.Then, frequency of observed cases by students and the fields used by the departments were calculated.

The students had not observed 5 diseases (26%) in orthopedic Dept., 6 diseases (50%) in neurology Dept., 15diseases (68%) in infectious diseases Dept. and 1 disease (6%) in toxicology Dept. But, all diseases had been observed in ENT Dept by students. Log books in Dept. of internal medicine were so incomplete that their data were not usable. Departments of orthopedics and neurology from outpatient clinics, Department of infectious diseases from hospitalization ward, Department of toxicology from emergency had the highest usage.

If students, faculty members and residents in educational departments know well about the importance and role of logbook and observe its function results, logbook can be used for evaluation of educational curriculum.

Self-directed learning development and promotion is one of the major goals of higher education. Since the students are expected to reach a level of individual competence at which they can detect and meet their educational needs without necessarily being in a special educational system and ultimately they can evaluate their learning. This research is a review on some articles published about self-directed learning in 1990-2008. literature review showed that self-directed learning has had an ascending growth, and this trend is continuing. Recently remarkable attention has been paid to self-directed learning and basic education for its promotion due to its benefits.

One of the most important and significant issues in students’ learning, is choosing and appropriate learning strategy. Today, Problem- Based Learning (PBL) as a metacognitive skill plays an important role in students learning. This study tried to study and compare utility rate of PBL by students of different schools in Isfahan University of Medical Sciences. This analytical descriptive study was done on 177 students of Isfahan University of Medical Sciences in 2009. Sampling was done by stratified random sampling method. The tool used was Metacognitive Awareness of Reading Strategies Inventory (MARSI) whose validity and reliability were both confirmed. Data were analyzed by SPSS 18 software using ANOVA test. There was a significant difference between the mean scores of PBL utility in students of different schools, the highest belonged to the School of Management with the score of 77.22± 10.8 and the lowest was that of School of Dentistry with the score of 57.83± 17.36. There was no significant difference among different university majors regarding PBL strategies utility rate. PBL is an active method and a metacognitive awareness in studying which could improve learning and academic achievement among students. So, the research and educational activities should lead the learners toward active and strategic learners. It is suggested that the educational system provide necessary education for students regarding applying PBL strategy.

Due to the increasing epidemic of chronic diseases, this study was performed to investigate the applicability of cognitive-behavioral trainings on recovery of chronic diseases. This study was performed through review, categorization, and evaluation of a number of related articles and books published during years of 2000 to 2010. findings showed that cognitive-behavioral trainings were effective in recovery of chronic diseases and their consequent complications both individually and along with pharmaceutical therapies. In spite of the fact that cognitive-behavioral training is in primary stages in treatment of chronic diseases, it could be used as an effective technique for treatment of chronic diseases and their consequences.

Teachers’ teaching style is effective on promotion of learning. To achieve this goal, teachers should use different teaching styles. This study has tried to determine teaching styles applied in basic sciences classes in Medical school of Isfahan University of Medical Sciences. In a descriptive study in 2008, 74 teachers of basic sciences in medical School of Isfahan University of Medical Sciences were selected through census sampling. The data collecting tool was TSA standard teaching style questionnaire including 61 items. The data were analyzed in form of mean and SD through SPSS. Based on the findings, %93.2 of teachers used flexible style in domain of teaching methods, %97.3 in classroom management, %71.6 in classroom design and %98.6 in lesson planning skills. It is recommended that teachers’ teaching styles be selected based on students’ preference. Educational workshops should also be held for teachers to make them familiar with students’ learning styles.

Clinical education is one of the most important and crucial parts of health science education. Successful clinical education needs to adopt effective approaches that are based on up to date knowledge, clients’ and patients’ needs. Therefore, it can prepare the learners for learning. This study aimed to introduce some new approaches in clinical education. In this review study, data gathering was done by searching electronic resources including Google search engine and scientific database as well as hand searching of library resources. So far, there have been several studies in the field of clinical education. Numerous approaches adopted or suggested by clinical education policy -makers to improve clinical competency of the learners of health sciences. This literature review has tried to introduce and discuss briefly some effective approaches including: 1) planned clinical experience, 2) dedicated education units and 3) integrating nursing process and problem solving. It is worthwhile for the clinical education programs to provide medical sciences learners with directed opportunities through which they can overcome their stress emerged from working in real clinical environment and apply their knowledge in the clinical practices.

Teamwork is the ability of all team members in making an effective communication, predicting and meet their demands and making reassurance due to cooperative group activities. Based on this description, we need to know how we can prepare students for effective teamwork. Since some class work and most clinical practices are done through teamwork and this continues even after graduation, we decided to determine the outcomes of the application of TMTD method from students’ point of view. This is a mix method study which done on postgraduate nursing student. Data gathering was done by a multiple choice questionnaire and open-ended questions. Then data were analyzed by qualitative and quantitative method. From 12 students participated in the study, only one student managed to get the complete grade, which was in the range of -10 to +30. Two students got 22 and the rest of the students got 26. Coding and categorizing open questions led to two main categories: positive effects and negative effects. Their perception of learning in a new method of teaching, pleasant class atmosphere, exiting teaching method, competition between teams, and lack of fatigue at the end of the class were the positive effects. The negative effects were too much effort for learning, distraction, and the newness of the method. In spite of being a new teaching method, the students eagerly tried to apply and learn from this method. In general, students got good grades in assessments. This could be due to the attraction of the new method, their level of education, or both those two and the efficacy of this method. It is suggested that teamwork training be planned in different courses, and its efficacy be assessed. Then gradually will be promoted in different curricula from primary schools to universities.

Regarding the significance of a doctor’s receptionist role as an important factor in promotion of health services in physician's offices, passing educational courses seems useful and somehow necessary for them. This study therefore was performed to evaluate the effect of office management principles on knowledge and performance of receptionists working in specialist's offices. In this quasi experimental study, 30 receptionists from gynecologist's offices of Isfahan were selected for an intervention through systematic random sampling. Education method was lecture and discussion. Data gathering tools were a questionnaire for knowledge assessment, and an observation checklist for performance evaluation which were employed before and after educational courses. Data were analyzed by descriptive and inferential statistical tests through SPSS software. Comparison of mean scores of knowledge and performance of the receptionists before attending office management principles courses(15.23, and 12.03 respectively) showed a significant difference with their mean scores of knowledge and performance after attending these courses (24.93, and 18.56 respectively). Regarding the findings of the study, it seems that great attention must be paid to the occupational structure of receptionists in physician's offices. Holding educational courses before employment as well as in service training for receptionists can promote patients’ visits process in specialist's offices.

The ultimate objective of scientific activities in organizations and universities is to ensure continuous expansion of these activities and to follow an ongoing knowledge improvement and development trail. Hence, this study was performed to investigate the knowledge management score between students of Isfahan University of Medical Sciences. In this descriptive study, the study population was 190 students of Isfahan University of Medical Sciences whom were selected through stratified random sampling. Data gathering tool was knowledge management questionnaire which its validity was confirmed. Data analysis was performed by SPSS software version 18 using descriptive and inferential statistics. The mean score of KNOWLEDGE MANAGEMENT was 60.22 ±10.39 among students. In general there was a significant relationship between KNOWLEDGE MANAGEMENT and gender (p<0.05). There was no significant relationship between KNOWLEDGE MANAGEMENT and age and educational level (p>0.05). Since scores of knowledge management among students was low and with regard to the fact that there are lots of rapid revolutions and alterations in different fields of science and technology and considering the increasing complexity and dynamics of environmental factors, university managers should plan for production, dissemination, and transmission of knowledge in universities.

One of the most important changes in medical education programs in Iran has been designing and implementing course of Introduction to Clinical Medicine (ICM) in Isfahan University of Medical Sciences. This study determines the methods and results of process evaluation (from CIPP evaluation) used for ICM revision and evaluation program. This study aimed to provide evidences about its efficiency and extract its executive disadvantages and limitation.

This is an evaluation study conducted in Isfahan University of Medical Sciences. Data were collected through descriptive studies and in most cases, self-administrated questionnaire was used. In some cases, comparing the final MCQ scores was used. This evaluation was done during conducting new ICM program. Separate evaluation tools were prepared in several steps and used for each course at the end of that. These Steps are literature review, preparing draft questionnaire, getting feedback from, and consulting with main stakeholders of evaluation and preparing the final questionnaires. The content and face validity of the questionnaires were confirmed by experts of education after conducting a pilot study and the reliability were checked by Cronbach's Alpha coefficient.

The results showed that the students have more positive attitude toward EBM course. Students believed that ICM was an appropriate section for learning medical records. They were not satisfied with management of medical records course by nursing department, identifying learning objectives and the extent of accessing to them, time devoted to this lesson, teaching method, sources and evaluation method. Evaluation of communication skills course showed students’ positive attitude toward this course and their learning of this course. Overall student's satisfaction in most items of ICM course (volume of ICM course, resources, evaluation methods, exams intervals, content of tests, arrangement of packages, volume of lessons, arrangement of practical courses, giving information) was more in old ICM program than the new one. Clinical students agreed with all changes. Mean score of sign and symptom and pathophysiology of disease showed a slight increase in new ICM program (insignificant statistically). Frequency of the failed student decreased from 18 student-units in old ICM program to 10 student-units in new one.

The results showed a relatively successful experience in reviewing and evaluating a medical education program. Regarding complexity of reviewing and evaluating medical education programs, this study can be used as a guide for designing other similar researches that are effective in future planning and decision-makings.

Educational objectives are the basic parts of educational programs, which guarantee achievement to the goals. Nowadays, there are no clearly defined educational objectives in course of general medicine, which causes the students to feel inefficiency and lose their motivation. This study has tried to define educational objectives and evaluate them as an effective step towards promotion of medical basic science education.

This is a descriptive analytical study. At first six teams including vice chancellor for education, department faculty members and experts of medical education were formed. Next, the educational objectives in course of limb anatomy, head and neck anatomy, anatomy of trunk, neuroanatomy, embryology and histology were defined in several sessions. Then, a 13-closed item questionnaire (in Likert scale, completely agree to absolutely disagree) was designed in order to determine students’ viewpoints regarding defined educational objectives. Moreover, after that its validity and reliability were confirmed, it was handed out to those students who had already passed the course. From 300 distributed questionnaires, 207 were filled and returned by the students. Data were analyzed through SPSS 16. In next step, levels of objectives- directed teaching process and goal achievement were checked by learning objective questionnaire (LOQ) filled by 23 students attending the course actively. Finally, the percentage of teachers’ attention to the goals of each course was determined.

After several sessions, 165 objectives in anatomy, 215 objectives in head and neck anatomy, 222 objectives in anatomy of trunk, 303 objectives in neuroanatomy, 250 objectives in embryology and 394 objectives in histology were designed. These objectives were converted to software sources, and after consultation with experts and a final revision given to students. The survey showed 78% of students used these objectives s in their studying within semester and 67% stated that having the goals helped them use better references. Analysis of LOQ questionnaires showed that in most of the courses, the defined objectives s had been followed accompanied with level of education and related reference in teachers’ teaching.

Preparation and designing educational easily available objectives and can be modified may be a basic step in promotion of medical basic science education. Consideration of these objectives in trend of medical students’ education is an important and inevitable issue.

Teaching and learning conditions & environment are crucial elements in acquiring skills and abilities during students’ education and also providing them with a satisfactory professional future. The purpose of this study was to assess teaching and learning environment in different sections of Isfahan dentistry school from the viewpoint of dentistry students. DREEM questionnaire was translated into Persian by two academic members and its validity and reliability were confirmed in a pilot study. The questionnaires were filled by second-sixth year students who had experienced the practical and theoretical courses in eleven clinical wards in Isfahan dentistry school at least twice. The data collected by 138 questionnaires were analyzed by SPSS. Total and mean scores of questionnaire in all wards were 99.75 and 1.99 respectively. Mean scores of questionnaire in 11 studied wards were 1.76- 2.90. Based on the obtained mean scores, the positive aspects of educational environment in surgical, internship, radiology, reconstructive and periodontology wards are less than the negative ones. In all wards, there is a significant gap between the present condition and standards so that educational environment needs to be improved.

Despite serious warnings about the possibility of infection transmission to patients, dental staffs are more at risk of cross infection. Since dentists’ attitude and professional behavior plays an important role in their health promotion and community, the aim of this investigation was to assess the attitude and practice of dentists of Isfahan in relation to HIV In a descriptive – cross sectional study, 237 dentists from Isfahan (Iran) were selected by randomized cluster sampling. A questionnaire regarding the dentist’s attitude and practice in relation with HIV and HBV infected patients was prepared. The questionnaires were distributed in private and public clinics and offices. Data analysis was done by descriptive statistics, ANOVA, and T test. (α=0.05) Mean total score of attitude and practice were 46.95 and 46.19, respectively (total score was 75 and 54). Score of specialist dentists’ attitude were significantly higher than general dentists’ attitude (P<0.001). Other demographic variables did not have significant impact in attitude and practice. Score of dentist in private office in comparison with clinics were significantly lower (P<0.05). Compliance of dentists in relation to proper infection control is good and partly acceptable but their attitude about AIDS & HBV is poor. Educational courses to address fear of dentists and guiding them about AIDS & HBV are recommended.

Hospital managers and service providers need to Hospital Information System (HIS) to increase the efficiency and effectiveness of the organization its goals. The basis for decision making, policymaking and planning at different levels of hospital management (including executive management, and clinical services) is detailed, accurate, timely and reliable information, and its interpretation, and this was done through proper training software users. This study aimed to assess the ability of user education in medical records module of selected HIS in Isfahan University of Medical Sciences. This research is an applied, descriptive cross sectional study, in which ability of users training modules of medical records in seven selected HIS in Isfahan University of Medical Science hospitals was assessed. It was based on the users’ experiences using ISO 9241/10 questionnaire including eight items (ranked fifth option in the Likert scale) in the second half of 1387. The International Organization for Standardization standardizes this questionnaire. Therefore, it was not possible to change questions. However, to ensure its admissibility and fitness for research environment, its content validity was confirmed (based on health information managers, health services managers, and computer science experts’ view) and the reliability was confirmed by test-retest (r =95%). The data gathering was done through referring directly to centers and training face to face all users (40 users), and then completing questionnaires. Data collected analysis was done by descriptive analysis (central tendency indices) and their standardization (converting to the relative frequency). Finally finding were classified in three categories including optimal (100% -81%), good (80% - 51%) and unfavorable (50% -0%). Data analysis showed that the time needed to learn how to use the system was unfavorable (48%), easy relearning of how to use this system after long term was desired (8/85%), support of system for user training was relatively desirable (68%), the lack of problems in learning rules for user relation with software was fairly good (8/78%). In addition, correct use of the software without asking colleagues was (60%) relatively favorable, encouraging users to test system performance with trial and error was (4/73%) relatively good, requiring to remember too much detail to use software correctly was (4/56%) fairly good, easy use of commands was (80%) fairly good, user education was (8/68%) fairly. According to the findings, it seems that software developers should decrease time needed for learning how to use the system, allow users to learn with HIS, answer users potential questions, allow testing system performance with trial and error, allows easy application of commands, and decrease problems about learning user communication with system in order to increase training ability.

One of the most important changes in medical education programs in Iran has been designing and implementing course of Introduction to Clinical Medicine (ICM) in Isfahan University of Medical Sciences. This study determines the methods and results of process evaluation (from CIPP evaluation) used for ICM revision and evaluation program. This study aimed to provide evidences about its efficiency and extract its executive disadvantages and limitation.

This is an evaluation study conducted in Isfahan University of Medical Sciences. Data were collected through descriptive studies and in most cases, self-administrated questionnaire was used. In some cases, comparing the final MCQ scores was used. This evaluation was done during conducting new ICM program. Separate evaluation tools were prepared in several steps and used for each course at the end of that. These Steps are literature review, preparing draft questionnaire, getting feedback from, and consulting with main stakeholders of evaluation and preparing the final questionnaires. The content and face validity of the questionnaires were confirmed by experts of education after conducting a pilot study and the reliability were checked by Cronbach's Alpha coefficient.

The results showed that the students have more positive attitude toward EBM course. Students believed that ICM was an appropriate section for learning medical records. They were not satisfied with management of medical records course by nursing department, identifying learning objectives and the extent of accessing to them, time devoted to this lesson, teaching method, sources and evaluation method. Evaluation of communication skills course showed students’ positive attitude toward this course and their learning of this course. Overall student's satisfaction in most items of ICM course (volume of ICM course, resources, evaluation methods, exams intervals, content of tests, arrangement of packages, volume of lessons, arrangement of practical courses, giving information) was more in old ICM program than the new one. Clinical students agreed with all changes. Mean score of sign and symptom and pathophysiology of disease showed a slight increase in new ICM program (insignificant statistically). Frequency of the failed student decreased from 18 student-units in old ICM program to 10 student-units in new one.

The results showed a relatively successful experience in reviewing and evaluating a medical education program. Regarding complexity of reviewing and evaluating medical education programs, this study can be used as a guide for designing other similar researches that are effective in future planning and decision-makings.

Ambulatory education has a great role in improving the abilities of medical students to encounter with common cases and according to Ministry regulations half of clinical education should be conducted in ambulatory seting.. This study is aimed at measuring quality of ambulatory education in Al-Zahra hospital, Isfahan, Iran. It can help to increase educational quality by recognition releif of current chalenges. This study is a descriptive, cross sectional research. It was conducted by designing a questionnaire and completing it by 180 clerkship students and interns. The questionnire consist of six areas: attending physicians’ teaching quality, residents’ quality of teaching, physical environment and facilities, patients’ affair, intern presence in ambulatory setting and duration of ambulatory teaching. The validity of the questionnaire was confirmed by educational experts and its reliability was measured through a pilot study (α=0.92). The conclusions in group of interns were as following: The mean score of attending physicians’ teaching quality, residents’ quality of teaching, physical environment and facilities, patients’ affair, intern presence in ambulatory setting and duration of ambulatory teaching were: 55.2, 52, 54, 61.5, 62.7 out of 100, respectively. Coresponding of scores for was 42.3, 42.7, 45.2, 56.6, 36.1, respectively. By the way, in both groups, interns and clerkship students, the mean suitable number of patients refer to clinics with the best educational output was estimated about 10 persons per day. Discusion: In conclusion, to improve ambulatory education, attending physicians should come to clinics on time and stay for longer duration than past. In addition, physical environment and facilities of clinics should be modified according to number of stagers and interns.

Critical Thinking is one of the most important skills for people of 21th century, especially for medical students. Emotional intelligence is another outstanding factor for success in all aspects of life, profession and education. It seems that both critical thinking and emotional intelligence altogether can play an important role in training professional doctors. The aim of this study was to evaluate the critical thinking skills of medical students and their relationship with emotional intelligence score of them in the first semester of 2010-2011 school year. The target group was all the students of the term 6 of medicine (n=69) in the Isfahan Medical University.California Critical Thinking Skills Test-(CCTST) with 5 subscales and Bar-On Emotional Quotient Inventory- EQ-i with 5 scales and 15 subscales were used for data collection. Data were analyzed by SPSS11.5, using descriptive statistics, Pearson's correlation coeffitient, paired-samples T-test and independent-samples T-test. Based on the findings, mean age of the target group was 22 years, and 72% of them were women. Mean score and standard deviation of Critical thinking test respectively were 11.96 out of 34 and 3.69. The mean score of deductive reasoning (6.12 out of 16) was significantly higher than inductive reasoning (4.92 out of 14). The total scores and standard deviation of Bar-On test were 330.7 (out of 450) and 34.29 respectively.There was no significant relationship between total score of Critical Thinking and Emotional Intelligence, except for the field of social responsibility of emotional intelligence that was directly related to Critical Thinking score (r=0.45, p=0.001). Although, mean score of critical thinking in medical students was not appropriate enough compared to the similar international studies, it was consistent with national ones. This can reflect the lack of critical thinking training in iranian educational curriculum. Lack of relationship between critical thinking and emotional intelligence scores might have been due to the difference in the type of questionnaires and students’ overestimation about their emotional abilities.

The first short term special course was held named as “diabetes educator nurse”. This article brifely reavealed the process of designing, performing and executive challenges of the course. Due to lack of previous history of courses for training diabetes nurse educator in Iran, wide literature review was done on credible sources. Mission, goals, course content, and training methods was determined based on obtained information from literature review, several meetings with endocrinology and metabolism specialists and faculty members of school of nursing and midwifery and considering the job description specified for the diabetes nurse in the Ministry of Health and Medical Education. Course was designed as a six-month course (280 hours including 100 hours theoretical issues, 180 hours practical issues). Accepting 30 volunteers were estimated in each course. A registration criterion was at least holding BSc in nursing. Passing criteria was gaining at least 16 score in theoretical and practical exam. Prepared core curriculum was send to department of continuing education in the Ministry of Health and Medical Education. Department of continuing education assessed prepared core curriculum, and then experts’ recommendations was done. Finally, curriculum was approved and allowed to be implemented. Considering challenges that First specialized course would be faced, course was hold by eight participants. The best teachers of endocrinology and metabolism specialists and best teachers of school of nursing and midwifery (Isfahan University of Medical Sciences) were used in teaching theoretical and practical topics. All learners could successfully finish the course. The successful holding of specialized training course in diabetes nurse educator increased motivation to hold this course again. However, holding this course again requires more support of health authorities in the province and country. In addition, there is need to revise executive principle of course in order to facilitate and attract more learner.

Assessment of national children growth has shown children‘s growth failure in a large percentage of them in Iran. Growth failure is easily diagnosed by growth monitoring card. On the other hand, mothers’ Knowledge of Nutritional development stages can help them to modify their practice in this field. In this case, conducting educational and interventional programs play a key role in promotion of mothers’ knowledge and practice. This study has been designed and conducted to compare the effect of two educational methods of lecture and self learning on mothers’ knowledge and practice. This is a quasi-experimental study conducted on 100 mothers with under 3 year old children. Samples were selected through random sampling and were randomly divided into two groups of lecture and self learning. Educational content included growth monitoring card, nutrition and nutritional development stages. A 45 item questionnaire whose validity and reliability had been confirmed in previous studies was used to collect the data. The collected data were analyzed by SPSS software. There was a significant difference between mothers’ Knowledge about growth and nutritional development stages before and three months after intervention. Although, There was no significant difference between mean scores of mothers’ knowledge about children’s growth in two studied methods, there was a significant difference in nutritional development stages (p<0.001).There was a significant difference in mothers’ practice mean scores before and three months after educational intervention (P<0.001). Mothers ‘Knowledge and practice about children growth and nutritional development stages are not appropriate so that education by each method is effective. Promotion of mothers’ knowledge and practice about nutritional development stages and their trend is necessary and must be programmed.

In recent decades, a variety of teaching methods has been offered for teaching different fields of science, but the old method of questions and answer is still popular and in use. This teaching method, generally applicable to small groups, is based on questioning and finding answers by students which can increase active learning. This study evaluated student's viewpoints toward clinical pathology teaching in laboratory using question and answer method. For this study students were divided into small groups, then clinical questions and appropriate resources for finding the answers were provided for them. They visited several units of hospital laboratory and a tutor taught them on laboratory procedures and their clinical significance to find the answers. At the end of the course, students were questioned about this teaching method. Sixthly seven percent of students believed that this method was more effective than traditional lecture method and 36.5% confirmed that group discussion was more beneficial than lecturing. But, 30% of students were against this method and opposed group learning. Totally, more than half of participants found this method effective and tended to learn clinical pathology through this method. About one third of students believed that lecturing alone is adequate for teaching clinical pathology but more than a half believed that presence at laboratory and the question and answer approach are effective and complementary techniques for learning this course. Learning through this method in laboratory is an effective way for teaching clinical pathology to medical students.

The most important goal of health systems is improvement of quality, effectiveness and efficiency of health services. To achieve this goal, health care organizations should establish a proper structure for evaluating health information systems. Health information system evaluation is expected to identify the existing problems of the system through measuring specific indicators. The main objective of planning health information system evaluation is to ensure availability of useful and utilizable data for measuring essential health indicators. Many researches have been done on health information systems evaluation indicators and stages. The current study overviews the previous studies and describes the suggested approach of World Health Organization to health information system evaluation which has been used in several countries. This program provides a comprehensive framework of health information systems evaluation. It is evident that determining the stages of the assessment program and its basic indicators will increase the effectiveness of health information system and subsequently improve health care.

Need assessment through testing the staff's skills and knowledge reveals the gap between the present and optimal situation and helps prioritize job needs. Educational need assessment is an essential step in developing educational programs and improving human resource's skills and knowledge. So this research was done to determine educational needs of medical records practitioner's in Isfahan teaching hospitals. This descriptive study was performed in 2008. The study sample included all medical records practitioners (N=77) in teaching hospitals affiliated with Isfahan University of Medical Sciences by census. Data collection was done through a researcher-designed questionnaire for assessing needs in three parts: technical, perceptual and human skills. The validity was confirmed by experts and the reliability by using coefficient Cronbach’s alpha (94%).For data analysis, descriptive statistics measures of frequency, mean, standard deviation, and inferential statistics measures of T- test and one-way variance test (ANOVA) by SPSS-11 were employed. As for technical skills, maximum educational need was related to filing unit(106.87±28.06) and minimum educational need related to admission unit(25.39±6.18). Regarding perceptional skills, maximum educational need was related to coding unit (57.58±6.08) and minimum educational need related to admission unit (50.50±16.3). Regarding human skills, maximum educational need (37.32±4.24) was related to admission unit and minimum educational need (33.50±11.27)was related to filing unit. According to the inferred priorities, it is necessary, through formulating and implementing educational programs, to promote and develop technical skills in filing sections, perceptual skills in coding and statistics sections, and human communication skills of staff in admission sections for medical records practitioners in Isfahan teaching hospitals.

Today self care behaviors education is the base of diabetes treatment and the nurses have been the special position in self care education in diabetic patients. The self care behaviors education history to diabetic patients had been speared changes that in this article we will review it and the nurses position in self care behaviors education to diabetic patients. This article is a review article about the history and changes in self care education to diabetic patients in the world, Iran and the nurses position in this field that has been assembled with study articles and nursing and diabetes scientific journals. The self care education to diabetic patients has one hundred years history. At first, doctors had a key role in self care education to diabetic patients, but now the diabetic patient's treatment in most countries has a team working approach and the nurses have a key role in this team and do the self care education to diabetic patients with different approaches such as group discussion, home visit, face to face education, education by telephone and …, and in this way face with barriers and lots of challenges such as lack of workforce in nursing system, lack of self motivation in diabetic patients, emotional stresses, lack of family supports, insufficient information about the importance of education in diabetes, fear of diabetes, problems of subway and … Self care education to diabetic patients had been a valuable and important strategy in field of diabetes control and for achieving to that, it is necessary to use a teamwork approach and use the variable education methods and omitting the existing barriers for nurses and diabetic patients.

Diabetes is a chronic illness which needs specific self care behaviors to the end of life. On the other hand, studies have shown that improvement in knowledge and practice of diabetic patients brings about improvement of metabolic status for which self care education specially with active method (active involvement of diabetic patients) is necessary. So, this study has been conducted to determine the effect of self care program with group discussion on knowledge and practice of diabetic adolescent girls referring to Iranian Diabetes Society. This research is a quasi experimental study conducted on 80 diabetic adolescent girls aged 15-19 (40 as experiment and 40 as control group) in Iranian Diabetes Society in 2008-2009. Self care program was designed after data had been collected in pre intervention stage by questionnaires of knowledge and practice as well as educational needs assessment in both groups, and then, self care program was administrated through 8 discussion sessions for experiment group. Finally, the same questionnaires were completed for experiment and control groups of diabetic adolescent girls once just after and one month after intervention again. The collected data were analyzed through SPSS 15 with statistical tests of X2, Independent Sample T test, Repeated Measures and Paired T test. Results showed no significant differences between experiment and control groups in demographic characteristics(age, height, weight, father’s job etc.) through Independent Sample T test and X2. In experiment group, there was a significant increase in scores of knowledge and practice compared to before, just after and one month after intervention (p<0.0001). But this difference was not significant in control group (P>0.05) and Independent T-test showed no significant difference in knowledge and practice between experiment and control groups before intervention(p>0.05). There was a significant difference in mean scores of knowledge and practice just after and one month after intervention between two groups of experiment and control shown by Independent T-test (p<0.05). Generally, the results showed that performing self care program by group discussion was effective on increasing knowledge and practice of diabetic adolescent girls and it is suggested to handle teaching self care behavior program by group discussion as an effective method to improve knowledge and practice in other adolescents with chronic diseases.

This study has tried to design educational program indicators for internal evaluation of graduate courses in health school. Regarding the systemic approach in educational framework, the related indicators have been categorized in three groups as input, process and output. First, indicators of graduate educational programs were defined based on different resources and scholar's comments through Delphi method and then the present educational status was revealed by the designed indicators. The data were collected by a questionnaire and through going over notes and evidences. The findings have been presented in form of charts and diagrams. In this study, total of 100 indicators related to educational programs were defined and investigated, based on three elements of input, process and output, in fields of academic members, educational programs, students, grants, facilities, structural indicators, official capacities, space and equipments, program management, learners, produced knowledge and scientific professional services. Regarding the findings related to the present condition and the possibility of comparing some indicators with those of four years ago, the following issues are suggested to be considered: Screening positive points of health school in domains of academic members regarding the number, variation and scientific rank, and present appropriate physical space, the necessity of conducting graduate education in health school and establishment of new courses, shifting attention to distant learning and online short term and open educational courses as a must for universities in direction of scientific and financial independency. There should also be reinforcement of data bases used by students, organizing the budget and school grants in dimensions of education and research, reinforcement of school interaction with industry with respect to school potentialities, holding refresher courses in form of continuing education programs, educational workshops and sabbaticals. It is suggested to make reinforcement of managerial staff's potentialities through holding educational courses specialized for managers and eventually to take actions to access main mission of the health school to produce knowledge and to distribute that through supporting students as well as provision of research culture and creativity among academic members to have a better scientific presentation through publications of articles in international ISI.

The first national medical science Olympiad suggested by Isfahan University of Medical Sciences was hold in 2009 in Isfahan. The venture had the mission to identify and flourish potentials in Iranian medical science students - the health system's capital. The ministry of health in collaboration with the affiliated universities hosted 364 medical science students. Students formed teams of three members and competed excitingly in a friendly atmosphere in solving problems which could help promote our health system or basic medical sciences. To reach better coordination, meetings with authorities of ministry of health and academic members of universities were held. 35 academic members from 13 universities formed committees to set questions/ problems to be discussed and solved. Questions were of Key features, scenario, script concordance, matching, and open ended types. Individual and group tests on three domains (clinical reasoning, basic science reasoning, and health system managerial reasoning) were held in 2 days each. To assess the quality of the tests and also the Olympiad itself, students were asked to take part in a survey. Most participants (94%) believed there was a difference between the Olympiad and the usual university exams. Also about 60% found the quality of the event satisfactory and 72% said they would encourage friends to take part in the following year’s Olympiad. It appears that such events, creating an exciting and happy atmosphere, could help nurture educational creativity in students and inspire them to go beyond routine studying and thus fill certain educational gaps in health system. The Olympiad being the first medical experience of the kind, further studies and modifications will certainly be necessary to improve it further.

Health system management is regarded a chief duty and skill of health care providers. However, medical students do not receive enough training for it. The first national Olympiad for students of medical sciences was designed to motivate students for acquiring managerial skills, improve reasoning and problem solving skills, and also propagate team working in students in an excitingly competitive and joyful atmosphere. Designing a model for the olympiad included four phases: building up a framework for designing the exam questions, determining topics of the exam, setting the exam questions and administering it, and finally judging. In summer 2009 the first national olympiad for the students of medical sciences on reasoning & decision making in health system management was held in Isfahan University of Medical Sciences. The first two days of the five-day-long open source olympiad were spent on individual competition. The following three days were devoted to group competitions. Six groups of three Students competed in this part. After 19 months, with the help of a large group of university teachers with related specialties, a framework for the selection of the exam questions was built up. The themes of the Olympiad were decided to be Health policy and health economics. The topic for group competition phase was current problems in implementation of the family physician project in Iran. In the individual competition phase, the students were to answer 194 questions and in the group phase they were asked 3 open-ended questions. 106 students studying different medical fields nationwide participated in the event; 71 students (66.98%) were girls. most participants were students of medicine (33 students) and others were students of nursing (26 students), health management (20 students), and other fields of study (27 students). Considering the significance of medical student's awareness of heath system management and the importance of improving reasoning and decision making abilities in them, holding such examinations could facilitate the achievement of these objectives.

There is no need to provide evidences or represent statistical proofs to demonstrate the revolution arising in information process and no one can deny the rapidity and clarity of the growth taking place in this domain. The matter of importance in this speedy procedure is that how social organizations hold their development or survive in this course. Organizations’ switch into learner unions is the suggested strategy here. Health system as one of the most critical social organizations also has to accomplish this learner being status in its development process and prepare its employees for presence in learner organizations. In this trend, because of the crucial function of learning and continuing medical education in updating information and knowledge in health systems and specific role of innovation and invention in achieving the goals, utilization of organizational models appropriate with information era is inevitable. Hence, learning organization as an appropriate pattern necessitates study and survey in its way of exploitation in health systems which demands for medical education researchers and administrators motivation.

Nowadays, efficient studying is considered as an important element in social development and progress through which the public and epecially university students gain a lot. Therefore, studying methods and skills should be considered in all educational levels, especially higher education.The purpose of this research is to determine the level of students’ familiarity with studying methods in Isfahan University of Medical Sciences (IUMS) in 2010. This is an applied survey research in which the data were collected by a researcher made questionnaire. Its validity and reliability were confirmed by library and information sciences specialists and cronbach's alpha (r=0.813) respectively. Statistical population consisted of all students in Isfahan University of Medical Scinces (5999 cases) and the samples were 357. Sampling method was random stratified sampling.Data were analyzed by descriptive (frequency destribution, mean…) and inferential (T-test, ANOVA) statistics through SPSS software. The findings showed that the mean level score of students familiarity in Isfahan University of Medical Sciences with survey reading and speed reading were 15.78 and 15.7 respectively (higher than average, mean average = 15). Familiarity level of students with phrase reading with mean 13.29 was higher than average (mean average = 12). Familiarity level of students with close reading was 29.6 that was higher than average (mean average = 27). Familiarity level of students with inquiry reading was 15.52, higher than average (mean average = 15). Also, familiarity level of students with critical reading and reading for aesthetic appraisal were 20.94 and 21.68 respectivley, higher than average (mean average = 18). Comparison between students ‘gender and the rate of familiarity with studying methods showed no significant difference. Also, familiarity level of students with studying methods was not the same in different colleges. The results showed that students’ familiarity levels with studying methods (survey reading, speed reading, phrase reading, close reading, inquiry reading,critical reading, reading for aesthetic appraisal) were higher than average in Isfahan University of Medical Sciences. Students were also more familiar with method of reading for aesthetic appraisal and less with speed reading. Generally, all students and education practitioners should pay special attention to various studying methods and their various applications.

Clinical reasoning is not only a critical skill in medicine, but also central to the clinical practice. Considering that there is no method of assessing clinical reasoning based on the theoretical framework of medical expertise research, we could approach assessment in an innovative way taking the model of clinical reasoning as a guide. In this model three major components of clinical reasoning (i.e. information gathering, hypothesis formation and hypothesis evaluation) have been measured, treating them collectively as a single score that reflects clinical reasoning competency. This battery permits the inclusion of different formats of clinical reasoning tests that cannot be administered simultaneously and assesses different aspects of clinical reasoning. This article explains the process of designing and implementing the battery of clinical reasoning in the first Olympiad for medical sciences students using action research method.

Clinical skills centers are one of the potentials in medical universities. Despite the huge spending in our country, these centers are used incompletely and undesirable. These review articles look at these centers, its application in some Iranian universities and foreign universities, and present some suggestions for optimal use of these centers in nationwide universities.

Evaluation of health information systems is an effective approach to ensure the efficacy of the system which can lead to the improvement in quality of health care services. The main aims of evaluation are to identify the strength and efficiency of system in health care delivery, to identify the weaknesses of the system, and to suggest general recommendations for improving the performance of the system. Evaluation could be performed through various methods. Some experts believe in three general methods including goal-based evaluation, goal-free evaluation and criteria-based evaluation. While some others consider two main methods for evaluation which are objective or quantitative and subjective or qualitative methods. Formative and summative methods are other classification of evaluation methods regarded by a number of researchers. This review represents various evaluation methods in health information systems and introduces the objectives and components to be evaluated in such systems.

In recent decades integration of pedagogic and technologic approaches resulted in a change in main structure of universities. Appearance and utility of electronic education especially in assessment system and examinations of medical students, necessitates designing new assessment methods and tools. This study is to discuss and design EPMP software as an appropriate tool for measurement of the ability in students’ clinical reasoning and problem solving. Regarding the structure of PMP examination, this software was designed in form of a three layer object generated using program C language and visual studio.Net with software base of SQL server 2000 as well as Ajax software to promote user interface (UI) to be used as an internet explorer IEO6. This soft ware represents patients’ problem in form of some text hints and fixed and animated pictures through simulation and then with some questions, lets the student or assistant follow up patients’ management and treatment. Because of the consistency of the designed software with international standards, this was welcomed by faculty members and assistants in university level and board of examinations. Assistants’ survey results showed their desire to hold these examinations with more frequencies within their education period and the potentiality to enable them to work with computer more skillfully.

while learning of the first diet therapy course is one of the most important issues, its teaching methods are important too. We aimed to compare the effect of teaching based on problem solving method versus lecturing method regarding first diet therapy course for students of nutritional science. This semi-experimental study was undertaken on 49 students of nutritional science in two semesters during 2008-2009 (25 students in the case group and 24 students in the control group). Similar sections were taught for both groups. The case group were taught using problem solving method, while control group were taught by lecturing with slide presentation. Pre-test and post-test evaluations were used to assessment of student's knowledge. Student's skill was evaluated by case study. The values were pointed between 0 to 20. Data analysis was done by SPSS software. The mean of knowledge scores in post-test were significantly higher in the case group (16.5±4.5 vs. 13.0±4.5). The scores regarding the student's skill were 13.5±5.0 after teaching based on problem solving method and 17.5±5.5 after lecturing method (P=0.04). Teaching the " diet therapy I course" using problem solving technique was more successful than lecturing method for enhancing student's knowledge and skills. Considering this method for nutritional science student is recommended.

In routine procedure, education of practical medical bacteriology is not related with job analysis. The aim of this study was designing and performance of practical medical bacteriology education based on job analysis. This interventional study was performed in second semester in 1388-1389 in the practical course of bacteriology for 40 second-year medical students. The students randomly were divided to two groups (control, case) and education was performed according to routine and new process and evaluated with questionnaire and posttest. Data analysis was done by SPSS. The mean of exam results in case group shows an increase of 8.5% comparing with control group According to questionnaire results all of the students were agree with necessity of change in educational program of practical bacteriology (63 and 91 in case and control group respectively). At the end of course, more than 70% of students in the case group achieved to the aims of the course (this was 9% in control group). The results of this study showed this method cause to more co-operations, interesting, and learning in practical courses. This new procedure is more related with job analysis comparing with routine methods. Students expect to learn issues that are more practical while common teaching methods address basic subjects regardless of the professional needs of students.

With regards to the importance and role of critical thinking in nursing, especially in clinical setting, achieving this goal(improving critical thinking) is very important. So nursing teachers encounter with the challenge of how asisting their students for promoting the critical thinking skills especially in clinical setting. The aim of this study is investigating the ways of improving critical thinking in students and suggesting implications in this field.

This study is a review article has done by searching the books, Databases such as Iranmedex- Irandoc-Magiran-SID-Ovid-PubMed,... using key words such as ‘critical thinking “,Students”,”clinical education”and “nursing”.

Nurses in goal- directed education need to critical thinking. For improving it, providing especial contexts is necessary. Achieving this goal necessitate knowledge, attitude, ability, preparedness and exercise. After the presence of this elements there is need skill to improving critical thinking. These skills include general critical thinking skills such as using scientific approach, hypothesizing, problem solving, decision making and especial critical thinking skills in clinical settings.

Improving cognitive and affective domains, motivating, developing imbalance and situations for interactions and balance between challenge and support, writing assignments such as short summary(approaching methodology, summarizing materials, is the way for critical thinking education)writing short analytical articles, problem solving exercises, using mass media research proposals and simulation are some ways, that in different situations by modifying and changing, can use for improving the students critical thinking.

Evaluation of student's viewpoints in order to improve and maintain continuous promotion of clinical education quality can lead to recognition and reinforcement of strong points and elimination of weak points of an educational system. The current study was carried out to evaluate the viewpoints of nursing and midwifery students about clinical education in Ilam University of Medical Sciences.

Tthrough a descriptive cross-sectional study using simple random sampling,90 nursing and midwifery students were studied; they had all at least passed one clerckship course in educational hospitals. Data was collected using a standard questionnaire. Data analysis was carried out through student’s t-test applying SPSS Ver.16.

From the viewpoints of the students, the affecting factors on clinical education are educator's characteristics (85.2%), educator's conduct (63.3%), supervision and evaluating components (61.5%, educational objectives and courses (52.2%, and clinical environment (42%) were the most important factors, respectively. T-test showed a significant difference between viewpoints of nursing and midwifery students on supervision and evaluating components(P<0.004).

Findings indicate that current nursing clinical educational status trends need to move toward providing more facilities and revising clinical evaluation methods. Also promoting clinical educato's teaching abilities can lead to improvement of clinical educational status.

Determining factors affecting teacher's evaluation from the student's point of view (learners) could greatly influence the quality of education. This study aims at identifying those characteristics which qulify a university teacher cabale in student's opinions.

In this descriptive, cross – sectional study, in 2009-2010, 800 students of Ilam University of medical sciences were selected. Multi – stage stratified random sampling was used for sample selection. A standard questionnaire was used for data collection, and data were analyzed afterwards.

68% of the students were female and 52.7% were undergraduates/PhD candidates. The mean for teaching style, interpersonal relationships, the teacher's personal characteristics and the knowledge seeking attitude of the teacher were 83.8±11.3, 83.7±13.9, 81.9±11.2 and 71.6±11.3, respectively. There was a significant relation between student's viewpoints and sex, their field of study, educational level and faculty (p<0.05).

Teaching style, interpersonal relationships, personal characteristics and the knowledge – seeking attitude were respective the most import characteristics of a capable University teacher. Student's needs, interests and viewpoints at different educational levels are not necessarily identical; therefore, it is suggested that these discrepancies be considered in educational planning.

After years of trying to make independent PhD course, Nursing could create two independent course including research-focused course (PhD) and clinical practice -focused (DNP). PhD focused more on research and DNP emphasis more on clinical activities and innovative clinical application of evidence-based research results. Presence or absence of DNP is still a debate as a challenge in nursing. In this paper, the authors compare these two doctoral nursing courses according to various sources

At most of the medical universities, MCQ-based examinations are often use as the first component, particularly to ensure the candidates have an adequate knowledge base, prior to entering subsequent clinical examinations.

In ICM, 3973 MCQs were collected from tests over a four-year period from 2005 to2009. Questions were evaluated for 10 frequently occurring item writing flows, for cognitive level and for difficulty and discrimination index.

Result show that 66.9% of the questions contained violations of item writing guidelines and79.1% were written at low cognitive levels. MCQs written at a low cognitive level were significantly more likely to contain item writing flows.47.3% of the questions had suitable discrimination index and 28.8% of the questions had suitable difficulty index. While there was no relationship between difficulty index and cognitive level, higher cognitive level and suitable discrimination index had significant relationship.

We should think about practically ways for using results of item analysis. Faculty members should be taught designing and using suitable questions and developing MCQs bank.

Much of the staff nurses make up the health system. So their education have huge impact on community health.One way to ensure their abilities is providing effective clinical education. So attention to variouse aspect of clinical education has been done.This study was done to analysis and discuse these dimentions. by using the key words clinical education, clinical environment,clinical educational problem, all related studies done between 2000 and 2010 were searched on ovid,iranmedex,medlib.The studies were assessed base on the areas discussed in the clinical education and 23 article were selected. Dimensions of clinical education philosophy seems by the fact the area are challenging that should be consider.So these are recommended for researching in nursing education.

Nursing education includes both theoretical and clinical areas, therefore it has special features and problems of its own. One is establishing integration between theoretical and clinical training. Patient's bedside teaching is considered to be an important component of clinical education. Time spent with the patient is full of visual, auditory and tactile experiences and therefore this type of training needs to be promoted. In this study, considering the current clinical training problems, we make a thorough overview of patient's bedside teaching as an important clinical training issue. This article is the result of reviewing more than 40 articles and books related to the topic. It covers issues such as different kinds of clinical training and their significance, their advantages and disadvantages, current problems and evaluation process. It also summarizes the literature and provides some solutions. The overview of patient's bedside teaching shows that this method is fading away and being substituted by teaching in auditoriums, classes, and corridors. Thus it is necessary to train faculty members to apply this teaching method. To do so, coordination between wards is needed to be made and regular evaluation must be done. Worldwide a number of studies have been done on patient's bedside teaching, but in our country, though problems of clinical training have been studied extensively, little has been done on patient's bedside teaching. It is hoped this could be a beginning for further studies.

The aim of this study is the evaluation of medical students’ academic achievement after the changes in arrangement and courses of some Basic sciences lessons in school of medicine and comparing their academic achievement before and after the changes in arrangement and the courses. In this descriptive analytical study 156 samples were selected from 2004 (group 1) and 2005 (group 2) medical freshmen. Changing courses, semester, and separating the lessons into smaller curses and elimination and addition were done in 24 Basic sciences lessons. Then the average scores of changed lessons and Basic Sciences comprehensive exams, demographic characteristics, failure rate and educational years were compared and analyzed in both groups. Data analysis was done by SPSS software using Chi–Square, Independent sample t test. This study showed that there is a significant difference between the mean score of following lessons. these are medical physics, physiology 1, theoretical pathology, practical and theoretical limb anatomy, physiology 1-a and 2-b and 2 practical and virology, theoretical bacteriology, practical trunk anatomy, practical head and neck, theoretical and practical immunology as well as the comprehensive exams mean scores (P=0.003) which increased after the changes in march 2008. The results of this study showed that changes had a positive effect on the mean scores of some lessons (including medical physics, physiology 1, theoretical pathology, theoretical and practical limb anatomy physiology 1-a and 2-b and 2 practical and virology.). However, it had a negative effect on the mean scores of some lesson i.e. theoretical bacteriology, applied trunk anatomy, applied head and neck anatomy, theoretical and practical immunology. The mean scores of the rest did not have a significant change and the mean scores of basic sciences comprehensive exams increased in both groups (P=0.003) which shows the changes were necessary and useful.

The purpose of teaching is learning, and learning is related to learning theories. These theories describe and explain how people learn. According to various expert's opinion about learning, many theories emerged. The paper reviewed three major approaches include behaviorism, cognitive and constructive learning and its educational applications in medical science. this paper review English articles selected from Medline and Eric databases and Persian articles from Medlib, Magiran databases between 1990 and 2011. The major applications of each of these learning theories in medical education can be mentioned as following. (a) Behaviorism: determining behavioral goals, computer based training, competency-based education, mastery learning, computer based simulation, (b) cognitive learning theories: advanced organization, concept maps, a community oriented medicine, learning from observation, and (c) constructivism: student-centered learning, problem-based learning, cognitive training, and reflective writing. In addition, basic features in each of these theories are described in a table. learning theories are not complete. Each emphasize on specific type of learning, so it is best for teachers to be familiar with all of them. Behaviorism in general is suitable for teaching new skills, cognitivism is appropriate for teaching critical thinking, clinical thinking, self - centered learning and productive life, and finally constructivism is proper for teaching problem solving skills, clinical decision making and communication skills.

In the classrooms of medical students, some times we can see problems that affect teaching quality. For solving common problems, some ways for effective teaching were selected. Including of pre-study, Computer-mediated learning package, quiz exam every teaching session, and group discussion. Then combination of this methods as PCQG model performed for pilot study in the kidney chapter of last edition of Robbins pathology text book. And the results were evaluated. This cross-sectional study was performed on Persian Bahman month according to solar year, term 88-89 for medical students of Isfahan University. Because of positive results again was done for next series of medical students in mehr 89. At first, student's were Asked to study before the classes, and for each of three sessions, one third of the text was determined (The pilot text was chapter of Kidney and urinary truct of 8th edition of Basic Pathology of Robbins). For this purpose a "training pakage" including of previous teachings and scan of the text was handovered a week before classes. Using Internet also was possible for the students. At the beginning of each sessions Quiz exam was given. In all sessions Insted of lecture, group discussion was conducted. Using multiple choice exam, likert scale questionnare and unstructural interviews with students, the effectiveness of this method was evaluated. The results indicates that 75 percent of students received acceptable scors from Quiz exam, 71/9 percent received acceptable scors from MCQ exam (moderate or good), and 73/9 percent received acceptable scors from total exam. On the other hand in opinion of the students this method could engage students in active discussions properly. Also cause good assessment of students learning, during the course done. This method as a new effective teaching/learning model can be expanded for educating various courses for students of medical sciences. PCQG model can be applied in provincial and national levels. P= Per-study C= Computer mediated Communication Q= Quiz G= Group.

Emotional intelligence is a developed form of human attention to the working environment. People with high emotional intelligence are efficient, productive and useful. This study compared management capabilities of health services management students and medical students based on indicators of emotional intelligence. This is descriptive analytical study. One hundred Health Management and medical students were selected in Isfahan University of medical science in 1385. Emotional intelligence was assessed using open questionnaires. Data analysis was done by SPSS software with t test and Pearson correlation. Between emotional intelligence in Health Management and Medical students (in each scale and total score) was not significantly different. Based on these results, management ability in health care management students and medical students cannot be determine based on indicators of emotional intelligence. Other researchers are recommended to review other variables.

ECT is an effective and unknown treatment in the psychiatric diseases for which the patients and their families have an illogical fear. Horror of brain injury due to ETC is always with the patients. This study is to investigate the effect of video education on decrease of ECT complications. In this blind study, the patients were given necessary education about ECT through a video film made by researcher and his team (about 25 minutes of lenght) before ETC by the personnel. Then,after the first session, during all other sessions and, at the last session,related questionnnaires were filled after patients were examined by the researcher.Each of the experiment and control group contained 30 samples. The mean of total ETC complications in the first stage was 2, the second stage 1.9, the third stage1.3 the forth stage1.3,the fifth stage 0.6 and the sixth stage it was 1.In educated and non educated groups in the first stage 2.3, the second 2.6,the third 1.9,the forth 2,the fifth 2.7 and the sixth it was 2.2.Education has somehow decreased the complications in stages 2,4,5 and 6 of ECT.There was a significant difference between reduction of headache in stage 5 of ETC and education,between memeory reduction disorder in stages 2 and 5 of ETC and education and finally between reduction of vomiting in stages 2 and 5 of ETC and education. Regarding the association between reduction of complications with education and its further reduction with repitition of watching the educational film,this study is counted as a valuable study which is recommended to be conducted with more samples and facilities.

Learning and performance of different people is influenced by an intrinsic clock and they can be classified into three groups: morningness, eveningness and non morningness-non eveningness. Cognitive performance of people is congruent with such rules and it approach maximum at different times of day. In higher education curriculum planning it is accepted to arrange difficult courses be presented early morning to seek better learning. This study is aimed at investigating the relationship of medical students’ academic merits with their morningness-eveningness schedule with regard to difficult and easy courses. this research is a retrograde descriptive –analytic study. Fifth semester medical students involved in this study. Their morningness-eveningness schedule was defined by the use of a 19 items questionnaire and they were asked to determine difficulty of different courses. The critical threshold for difficulty of each course was considered by 50%. Students’ manuscripts extracted from medical school educational officials. SPSS software (ver 11.5) was used for data analysis through “t”, ANOVA and multiple regression. 63(67% female and 33% male) students participate in the study. Physiology, pathology and parasitology were considered as difficult courses and Islamic ethics, nutrition, analytical history of islam, practical parasitology and physiology considered as easy courses. 11%, 60% and 29% of students were considered morningness, nonmorningness-noneveningness and eveningness, respectively. As a result, eveningness females have a considerable decrease in difficult courses (Pvalue of physiology=0.009, pathology=0.005 and parasitology=0.059). Such decrease in males was not significant. Although, it is believed that difficult courses should be presented in early morning for better learning this study shows that eveningness students’ performance may decline significantly and it is recommended to arrange for difficult courses to be presented in special times for better performance of all students categories.

this study is aimed at investigating faculty’s and students’ perspective whether health social workers can be hired as substitute for evaluators or as a co-evaluator for clerkship students assesmet in community medicine course? this research is a cross-sectional study. The study has been conducted by participation of medical students assigned to pass comunity medicine course in January 2011. An OSCE designed for evaluation of medical students’ competencies. It consist of eight stations. In each health care center a faculty member and a social health worker were assigned for evaluation of students. For each station a chekclist devised to measure the competency and its validity was assured by experts. Its reliability was measured (α=0.83). All data was analyzed by SPSS software (version 14). In all stations, except one, a significant corralation was measured between the results of faculty and health care workers evaluation (P<0.05, r=0.86). All faculties and instructors aknowledge that social health workers can not be trusted for medical students evaluatin. 83.3% declared that community medicine department can ask for health care workers to evaluate medical stuents globally. Considering social health care workers’ competencies, perhaps it is ineligible to ask for social health workers to evaluate medical students but they can participate in the exam as standard patients.

Determination of psychometric properties including predictive validity, especially in university entrance examination (especially for subjects that are long, expensive and important for public health) is one of the major studies that should be done and considered frequently by the Assessment Organization. This study aimed to determine predictive validity of university entrance exam in predicting the educational success of medical students. One hundred fifty seven (157) medical students admitted in 1383 in Isfahan University of medical science were reviewed. Scores of specific courses (biology, physics, mathematics and chemistry) and a general course (English) in the university entrance examination as the predictor variables and exam scores in the Comprehensive Test of Basic Medical Sciences as the criterion variable was considered. Data analysis was done using Pearson correlation and multiple regression analysis. All test materials had significant correlations with criterion variables (in simple correlation between predictive and criterion variables). Modeling using multiple regressions shows that only biology course was significant productivity. Among predictor variables, the biological and mathematical scores had higher Predictive validity than other variables.

Echocardiography is a diagnostic test in that ultrasound waves are used for producing images of the heart muscle and valves. Echocardiography provides a series of useful information about the heart and its function for treatment purpose. It is especially useful for assessing valvular heart disease. Although it has no known side effect, but similar to any other medical procedure, it is associated with stress and discomfort. Hence, trusting and eliminating patient's stress should be started from the first moment. This study review beneficial effects, method, and possible side effects of echocardiography and assess the effect of face-to-face training and pamphlets in reducing anxiety. In this clinical trial, 7-25 year children referring echocardiography center of Hajar hospital in Shahrekord was selected by convinced sampling. 90 selected subjects randomly allocated into three groups of 30 subjects (one control group and two groups) groups. Pamphlets and booklets about echocardiography and face-to-face education by a physician for 15 minutes were presented to two groups. Spielbergers anxiety questionnaire were filled before and after training. Data analysis was done by SPSS software using chi square tests, ANOVA and paired t test. Obvious Anxiety prior to echocardiography, in the trained group by Pamphlets was 47/9±9/6, in the trained group by face-to-face education 48/2±11/5, And in control group 46/5±31/1 respectively. In spite of decreasing obvious and hidden anxiety after echocardiography (P<0/05), there was no significant difference in obvious and hidden anxiety levels after training among the three groups (P>0/05). In all groups, obvious anxiety after echocardiography was significantly less than anxiety before echocardiography. Although hidden anxiety after echocardiography decreased in control group and trained group by face-to-face education, but it has not changed in the trained group by Pamphlets. anyway in the three groups was not significantly different.

Verbal language is Fundamental component for expressing ideas, social interaction and understanding educational materials. Effective communications require verbal language skills. Sound pillows may partly address the children with behavior problems. The purpose of this study was assessing the effect of educational sound pillow in the treatment of stuttering and cognitive phonemes impairment in children. This is a clinical trial study in which the statistical community, including pre-school children to children who finish primary school in Shahrekord who referring to pediatric psychiatric clinic for treatment. Twenty-seven Children with stuttering randomly assigned to control group (13 children who will treated with speech therapy) and case group (14 children who will treat with speech therapy and sound pillow). Tthirty-three children with cognitive phonemes impairment randomly assigned to control group (17 children who will treated with speech therapy) and case group (16 children who will treat with speech therapy and sound pillow). Group therapy was hold twice a week, each session for forty minutes in which children treated with speech therapy techniques. In case group in addition to speech therapy sound pillow was used, three sessions a week each meeting for half an hour (15 minutes at the beginning of sleep and 15 minutes at the end of sleep) for a month. Intensity of abnormalities was measured before and after treatment. Data analysis was done by SPSS software with Wilcoxon signed rank tests and Mannwithny test. Severity of Stuttering and cognitive phonemes impairment in both groups were similar before treatment (P>0/05). Significant decrease in the severity of stuttering and cognitive phonemes impairment was occurred after treatment in both groups (P<0/05). There was no Significant difference in the severity of stuttering and cognitive phonemes impairment after treatment in both groups (P>0/05).In other words, adding sound pillow had no effects on the treatment of stuttering and cognitive phonemes impairment. Adding sound pillow to conventional treatment (speech therapy) had no effects on the treatment of stuttering and cognitive phonemes impairment.

Menopausal women are at risk of chronic diseases due to estrogen deficiency.One of the most effective ways for prevention and control of chronic diseases in menopausal women is changing their nutritional behavior. A randomized interventional study was conducted on154 menopausal women in Isfahan. In the intervention group, the training was based on HBM and certain behavior goals and continued for about two 120- minute sessions. Data were collected by a valid and reliable questionnaire. The questionnaire was completed before and after the educational program(two times- one immediately after it for assessing knowedge and HBM components, and the other, two months after it to assess nutritional behavior change) by menopausal women. The collected data were analyzed by SPSS. The result of this study showed a significant increase in the mean scores of the knowledge (pretest=8.03 ± 1.24 to post test= 9/92 ± 0.25, P<0.001) and HBM components after intervention (P<0.001)and also those of nutritional behavior before receiving education and 2 months after it (pretest=28.91 ± 5.13 to post test= 43.51 ± 2.36, P<0.001) significantly increased the in experimental group The findings of this study confirmed the effectiveness of the HBM – based educational program on improving the nutritional behavior in menopausal women.It is suggested that the HBM-based educational model used in this study be employed in medical health centers.

More people in the world have lack access to formal pre-hospital emergency. Pre-hospital system should be simple, efficient, and continuous. In emergencies, Caring interventions and in pre-hospital environment is based on independent judgments, decision-making skills, and prioritizations, which is achieved through the training. This study aimed to discuses about current educational methods of pre-hospital emergency in Iran in comparison with other countries. With real assessment of learning in emergency, it is possible to determine gaps between needs and learned materials in order to eliminate it. In this review, data gathering was done through medical education and emergency related-textbooks, databases including Pub Med, CINAHL, Embase, Pro Quest, and Science Direct. At first step, 2345 article was found. Finally, 29 articles were selected based on purpose of study. The findings of this study showed that the training of nursing student and other student that allowed working in pre-hospital setting are not efficient and appropriate. This study showed that in current situation it is necessary to reconsider changes in the educational content and methods used for pre-hospital emergency education.

In order to improve the motivation and attitude of the elderly for regular and continuous physical activity, it is inevitable to use methods and models of effective education. Spiritual doctrine can improve the elderly's motivation for activity increase. This study was performed to assess the effect of faith-based education on physical activity and compare that with routine education (non faith- based) on the elderly in 2011.

A quasi-experimental field trial study was done on a number of the elderly of Isfahan pensioners in two random groups: control) 53 sample) and experiment (45 sample). The educational content was prepared in two kinds of faith- based and routine education. The researcher-made questionnaire whicht was derived from a valid questionnaire _ physical activity scale for elderly (PASE) _ was used to estimate the elderly's physical activity before and after the educational intervention in the two groups.

Before the educational intervention, the physical activity score for the experiment group was 873.15±197.98 and for the control group, it was 864.15±269.85, which were not statistically significant (P=0.853). After the intervention, the score for the experiment group was 944.09± 262.88 and for the control group, it was 930.60±259.03.This showed a statistically significant differences. (P =0.043 in the experiment group and P=0.045 in the control group), but despite a little difference, there was statistically no significant differences between the groups.

The level of elderlies physical activity improved after two kinds of education and faith based teaching hadnt obvious differences in outcome than routine education.

Presence of up-to-date knowledge, sufficient incentive and knowing the methods for clinical skills performance are the most crucial basics for patient care. In this study, influence of instruction based on the study guide will be investigated on the clinical competence and satisfaction of students. This study is a quasi-experimental research. 37 nursing students participates in this study. The study conducted in CCU ward. First, study guide for CCU ward prepared. Then, participants divided into two groups: control and experimental group. Control group take the course as a formal course and then experimental group take the course by the use of study guide. At the end of each course an OSCE devised for measurement of clinical skills competencies. SPSS software (version 11.5) used for data analysis and means compared by the use of student “t” test and Leven test.. The clinical competencies of experimental group improved ahead of control group. (P value=0.002). 88.3% of students satisfied because of study guide usage for learning clinical competencies. The findings of study shows that use of study guide can be helpful for improving quality of education and students’ satisfaction. It is congruent with other studies.

Educational methods can be classified into two groups: active methods and passive ones. Applying games is an active approach in teaching. The present study aimed at investigating the effect of games on teaching oncology. Twenty three medical students participated in the study. They took two class sessions of oncology. In the first session the basic principles and concepts on oncology were taought and in the second session, they were randomly divided in two groups. A selected modified text of esophagus cancer treatment from up-to-date version 17.3 was presented to both groups. Some especial cards containing a cancer treatment modality were given to the case group. The students were asked to sequence the possible treatments for the case. At the end of the session, esophagus cancer treatment was presented to the students. The students’ responses were gathered, scored and compared applying T test. They were 12 in the experiment and 11 in the control group. There was a statistically significant difference between the mean score of the control (28.46 ± 22.6) and experiment(55.8±26.1)groups, (t=2.67, df =17.63, p=0.016). The number of sequences proposed by the control group was (4.85 ± 1.72), while the number of sequences in the experiment group was 3.85 ± 0.07, resulting in t=2.54, df =16.751, p=0.021. The mean score in the experiment group is significantly higher than that of the control group. Although the time spent was equal in both groups, the game lead to more concentration and deeper learning in the experiment group. Significantly, the number of treatment sequences in the experiment group is lower than that of the control group. It seems that treatment selection was done more delicately and responsibly by the experiment group. So, teaching oncology through games can increase learning in medical students, which in turn,leads to better treatment selection and problem solving.

Attention to professionalism in pharmacy on the one hand, and imposing the students to pass eight credits of dissertation, as well as lack of systematic principles of thinking and research in course syllabus from the other hand, emphasize on a need for including the course of thinking and research methodology in course syllabus of pharmacy. Through numerous structured interviews with academic members, graduated students and students of pharmacy, the needed outlines of the course were prepared and approved. Then, the course was taught in form of a one credit subject, and at the end of the course, student’s view points regarding this course was collected through a survey. Approved outlines such as personal professional skills, research principles and methods were taught in the first semester of 2008-2009. The survey showed that in addition to student's satisfaction, they emphasized on increasing the number of its credits. This study not only showed a need among pharmacy students for a systematic thinking and research principles but proved the applicability and appropriateness of this course as well.